Urgently refer children with suspected E. coli, GPs told

GPs should seek immediate specialist advice when a child is suspected to have Escherichia coli infection, under guidelines from the Health Protection Agency (HPA).

Cases of acute bloody diarrhoea in children linked to the most common E. coli strain, O157, are rare (Photograph: SPL)
Cases of acute bloody diarrhoea in children linked to the most common E. coli strain, O157, are rare (Photograph: SPL)

A single episode of acute bloody diarrhoea in a child should trigger GPs to urgently contact specialist secondary care for advice, the HPA guideline states.

Significant dehydration, acute abdominal pain or other signs or symptoms should lead to an emergency referral.

The guideline also recommends that all clinical staff are aware of the need for urgent public health action where E. coli infection is suspected.

Cases of acute bloody diarrhoea in children linked to the most common E. coli strain, O157, are rare. Each year 300-500 cases in children are reported to the HPA.

Lead author Dr Nick Gent at the HPA, said: ‘ As some cases can lead to kidney failure and fatalities, urgent reporting and referral is necessary to ensure children receive specialist paediatric assessment and have the best chance of recovery.’

Dr Maureen Baker, health protection lead at the RCGP, said: ‘This guidance is extremely useful in that it will support GPs and practice teams in correct management of this condition and help provide important reassurance to parents and their children.’

The HPA guidelines support existing NICE guidance on the management of diarrhoea and vomiting in children under five years.

It has been endorsed by the RCGP and the Royal College of Paediatrics and Child Health.

Click here to download the HPA guideline

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